The relationship between psychotic-like symptoms and neurocognitive performance in a general adolescent psychiatric sample

Lindgren, Maija; Manninen, Marko; Laajasalo, Taina; Mustonen, Ulla; Kalska, Hely; Suvisaari, Jaana; Moilanen, Kari; Cannon, Tyrone D.; Huttunen, Matti; Therman, Sebastian

doi:10.1016/j.schres.2010.07.025

« Previous Next »Schizophrenia Research
Volume 123, Issue 1 , Pages 77-85, October 2010

The relationship between psychotic-like symptoms and neurocognitive performance in a general adolescent psychiatric sample

Maija Lindgren
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
- Corresponding author. PL 30, 00271 Helsinki, Finland. Tel.: +358 20 610 8659; fax: +358 20 761307.
Marko Manninen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
Taina Laajasalo
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
Ulla Mustonen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
Hely Kalska
- Department of Psychology, University of Helsinki, Helsinki, Finland
Jaana Suvisaari
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
Kari Moilanen
- Hospital District of Helsinki and Uusimaa, Helsinki, Finland
Tyrone D. Cannon
- Departments of Psychology and Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA, USA
Matti Huttunen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
Sebastian Therman
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland

Received 20 January 2010; received in revised form 15 July 2010; accepted 24 July 2010. published online 23 August 2010.

Abstract

Introduction

The current criteria for detecting a Clinical High-Risk (CHR) state for psychosis do not address cognitive impairment. A first step for identifying cognitive markers of psychosis risk would be to determine which aspects of neurocognitive performance are related with more severe psychotic-like symptoms. This study assessed cognitive impairment associated with prodromal symptoms in adolescents receiving public psychiatric treatment.

Methods

189 adolescents were recruited from consecutive new patients aged 15–18 attending mainly outpatient adolescent psychiatric units in Helsinki. They had been screened for prodromal symptoms using the Prodromal Questionnaire, and all screen-positives as well as a random sample of screen-negatives were interviewed using the Structured Interview for Prodromal Symptoms (SIPS) and underwent testing using a large, standardized neurocognitive test battery. The sample included 62 adolescents who met the CHR criteria (CHR) and 112 who did not (non-CHR). A healthy control sample (n=72) was also included to provide age- and gender-matched norms.

Results

The CHR group performed worse on visuospatial tasks than the non-CHR group. Among CHR adolescents, negative symptoms were associated with slower processing speed and poorer performance on verbal tasks. Among non-CHR adolescents, positive symptoms were associated with poorer performance on visuospatial tasks, and negative symptoms with poorer performance on verbal tasks.

Conclusion

Clinical high-risk status is associated with impaired visuospatial task performance. However, both positive, psychotic-like symptoms and negative symptoms are associated with lower levels of neurocognitive functioning among adolescents in psychiatric treatment regardless of whether CHR criteria are met. Thus, even mild positive and negative symptoms may have clinical relevance in adolescents in psychiatric care. Adolescents with both psychotic-like symptoms and neurocognitive deficits constitute a group requiring special attention.

Keywords: Prodrome, CHR, Psychosis, Neuropsychology, Neurocognition, Adolescents